[core0]

Originally Posted by ANPFNPGNP

If you figure in the salaries of CRNA's, then the NP's blow the PA's out of the water.

If CRNAs were NPs that would be true. Or you could include CNS in the equation and then the NP average salary would be less.

David Carpenter, PA-C

[jlcole45]

Actually here in NC - the PA clinical is 2000 hrs (and no clinical experience is necessary prior to school) and the FNP at Duke University is 816 hrs - with the requirement of at least one year of nursing experience - so tack on 2000 hrs. And to be honest most of us RN's have more then 1 year experience before going back for a Master's degree.

The difference occurs with how the NP or PA are utilized and treated by the physician, not so much in their training. They both can function quite independently, it's just a matter of how much trust the overseeing MD has in their abilities. For real hands on experience as a FNP work in a rural clinic - that's where you can be very independent. The problem with big city ER's is that everyone wants to work at them and so there is always a struggle of who gets to do what.

[caldje]

Originally Posted by jlcole45

Actually here in NC - the PA clinical is 2000 hrs (and no clinical experience is necessary prior to school) and the FNP at Duke University is 816 hrs - with the requirement of at least one year of nursing experience - so tack on 2000 hrs. And to be honest most of us RN's have more then 1 year experience before going back for a Master's degree.

Do you see the logical error in this statement. You start by saying that the PA school has more clinicals in the PA program but doesn't require prior experience. (completely ignoring that most people in the program still DO have prior experience) However, when you list the hours of training in the FNP program (less than half that of the PA program) you put an * beside it and say but we are required to have a year of RN experience (whether it is applicable to FNP practice or not) and take the opportunity to say BUT most have more than that.

It just seemed kind of slanted to me.

The second portion of your post was very well put though.

[dhigbee]

I would think that most any hospital nursing experience would help to prepare for the nurse practitioner role. I never planned to be a hospital nurse long-term, but I "did my dues" in preparation for obtaining a masters degree. Specifically, I learned much about health assessment, patient responses to disease processes, disease management, current medical therapy, monitoring lab results, time management... I could go on and on. In addition, the people skills one learns (both with other medical staff and with patients) are invaluable.

Dana

[hotomalis]

"I know quite a few of these A.S. PAs as, until recently, the local PA program was held a local Community College in conjunction with the local medical school. Most are quite good. Most also had a BA/BS in something in order to get in as the competition for the seats was quite high.

The program is now at the medical college as a MS level program. Actually, I don't think that they changed much - just the level of degree.

There is a PA program offered by the U. North Dakota (or is it So. Dakota?) which requires a BSN for admission. It has only 16 weeks on campus with the rest of the two years in a PCP office near your home.

Chip"

In reality, 1 or 13 years don't matter if you are a bad healthcare worker. I've known MD's who do not care what they do or who they do it to and they are veterans at their profession.

I know the program you are talking about. Is not that they require a BSN, is just that if you have a BSN, you have most of the requirements needed to enter the PA program.

I am recovering from cancer and all my healthcare team is female, MD, PA and NP's, oncology, surgery, and plastics. My favorite is my oncology NP and that's just because she listens to me and my worries. Not because she has 19 years under her belt. The surgeon had her intern come in and he was dismissive and callous. The day of my surgery I was in tears because of my disfigured breasts. He didn't say his name, he didn't introduce the PA student, the conversation was just between the PA student and the intern. The intern asked me to lift my gown to see the surgery. I asked him for his name and he said it and without losing a beat, he asked me again to lift my gown. I told him to get out of my room but the student could stay. The intern said he couldn't do that and walked away. The PA student apologize and wished me well and also stated he understood why I did what I did. I asked him to come back and would tell him everything I knew about my surgery.
It's not what letters go after your name or what people call you professionaly. It is really how your patients see you, and how safe you feel with them. I, for one, did not feel safe with the intern but my Onco NP, my plastics NP and the general surgeon were very good at their jobs and were kind. The PA learned not to be a pompous ass like that intern and got more information.
The PA ended up coming back the next day before going home. We talked and I begged him never to lose his humanity. I actually complained to my general surgeon about this intern and told her about the PA. On my last visit she thanked me for having referred the PA to her. He now works in that practice.
By the way, does anyone here know nurse practitioners do have complete independence in 13 states? and it's growing people...very soon we will have primary care in every state...
Also, can someone tell me about education? When a PA graduates, how many years of education can he/she achieve (at the most) before practicing (hands on patients)? How many years before a BSN? MSN? Anyone care to write it down somewhere? We need to educate our fellow HC workers who may be a little confused about our capabilities.
Did you know that NP's can have independent practice in the rural areas of Texas? Because most doctors (MOST) don't want to practice in a rinky dinky town. There is not money there. Yep! This was something a doctor working at Baylor University Medical Center told me... I read the Texas statutes and behold, it was true!

[caldje]

thanks for sharing such a personal story. It always helps to hear these kinds of things.. Keeps us realizing what we are doing on a daily basis.

Also remember, it doesn't have to be cancer to be important either. I hope I can always remember how significant the things that may seem 'little' to us really are to the patients and their families.

I will let David answer your question about PA training cuz he can do it without making anyone mad.

[core0]

Originally Posted by hotomalis

In reality, 1 or 13 years don't matter if you are a bad healthcare worker. I've known MD's who do not care what they do or who they do it to and they are veterans at their profession.

I know the program you are talking about. Is not that they require a BSN, is just that if you have a BSN, you have most of the requirements needed to enter the PA program.

I am recovering from cancer and all my healthcare team is female, MD, PA and NP's, oncology, surgery, and plastics. My favorite is my oncology NP and that's just because she listens to me and my worries. Not because she has 19 years under her belt. The surgeon had her intern come in and he was dismissive and callous. The day of my surgery I was in tears because of my disfigured breasts. He didn't say his name, he didn't introduce the PA student, the conversation was just between the PA student and the intern. The intern asked me to lift my gown to see the surgery. I asked him for his name and he said it and without losing a beat, he asked me again to lift my gown. I told him to get out of my room but the student could stay. The intern said he couldn't do that and walked away. The PA student apologize and wished me well and also stated he understood why I did what I did. I asked him to come back and would tell him everything I knew about my surgery.
It's not what letters go after your name or what people call you professionaly. It is really how your patients see you, and how safe you feel with them. I, for one, did not feel safe with the intern but my Onco NP, my plastics NP and the general surgeon were very good at their jobs and were kind. The PA learned not to be a pompous ass like that intern and got more information.
The PA ended up coming back the next day before going home. We talked and I begged him never to lose his humanity. I actually complained to my general surgeon about this intern and told her about the PA. On my last visit she thanked me for having referred the PA to her. He now works in that practice.
By the way, does anyone here know nurse practitioners do have complete independence in 13 states? and it's growing people...very soon we will have primary care in every state...
Also, can someone tell me about education? When a PA graduates, how many years of education can he/she achieve (at the most) before practicing (hands on patients)? How many years before a BSN? MSN? Anyone care to write it down somewhere? We need to educate our fellow HC workers who may be a little confused about our capabilities.
Did you know that NP's can have independent practice in the rural areas of Texas? Because most doctors (MOST) don't want to practice in a rinky dinky town. There is not money there. Yep! This was something a doctor working at Baylor University Medical Center told me... I read the Texas statutes and behold, it was true!

As far as Texas I would suggest you reread the statues, specifically rule 221.13 (link won't post)
For reasons that are unclear NPs in rural areas actually have more supervision requirements than those that aren't.
As an alternative the Pearson report is fairly definitive:
http://www.webnp.net/downloads/pears...na_wyoming.pdf

I have the list of NP states at home. I can post it later. As discussed in other posts Medicare requires a collaborating physician to bill.

As far PA education, PA educational programs range from 18-36 months. They usually encompass a didactic and a clinical phase although a number of programs are integrating their clinical phase in PBL. The great majority of PA programs are 24-27 months. After graduating a small minority of PAs go on to post graduate programs in Medicine or Surgery. The rest enter practice.

You can probably find the rest of the information (including the part that I posted) in the previous 37 pages of posts. Or perhaps someone will post it.

David Carpenter, PA-C

[hotomalis]

Isn't that funny? I can't trust MD's telling me the truth about my own practice, hum! aren't MD's the ones that regulate what NP's can and can not do? don't they also delegate? I wonder why this guy told me that? I did go to that clinic (while doing my rotation for Community Nursing) and I never saw a doctor there and I was there for 12 hr days...weird.

[tanthalas]

(From page 24)

Originally Posted by core0

That being said, the vast majority of "holistic" medicine is simply ineffective. While most is not harmful, some is or may delay patients seeking better treatment options.

That's quite the bold statement.

[ANPFNPGNP]

Originally Posted by hotomalis

Did you know that NP's can have independent practice in the rural areas of Texas?

I practice in Texas and it is not true that NP's can practice independently in rural areas. We are fighting for full independence at this time (it's currently before the legislature) and we're hoping to "settle" for independence in rural areas.